Blogs posted for BMJ, Public health issues in Asia

Jane Parry on flu

Hong Kongers have lived through more than their fair share of bird flu scares across the border in China over the last few years, and, of course, Sars in 2003 when 299 people in the city died of the disease. Then there was the cull of Hong Kong’s entire poultry population back in 1997. It’s not surprising, then that 7 million residents of this crowded city are a little twitchy about pandemic flu threats.

The news about a suspicious outbreak of swine flu in Mexico emerged here on Friday April 24, and the news only got more sinister over the weekend. Today, Monday, while I was out running errands anyway, I decided to pop into my favourite pharmacy and pick up an extra supply of surgical masks for myself, my husband and our two children. Like every Hong Kong family, we keep a supply, because children are required to wear them to school if they have a cough or a sniffle, and a lot of adults use them in the same way, a post-Sars behavior change that has become a common courtesy to others when in public.

I checked our surgical mask stocks and reckoned we’d get through them in less than a week. The pharmacist told me he’d fielded 20-odd requests for masks by lunchtime today, but all those looking for adult-size masks were turned away empty handed- he’d already sold out by the middle of Sunday, just 48 hours after the first news report. Hong Kongers react fast, given that the nearest outbreak to us so far was in New Zealand. I was able to score a box of 30 each for my 10-year-old and six-year-old children, in kiddie sizes, with a promise he’d have more supplies soon.

Next item on my list was a packet of Tamiflu. It’s a prescription drug here too, but if you know which pharmacists to go to, you can buy pretty much anything in Hong Kong OTC. That’s why this guy is my favourite- he’ll let me self-prescribe and I have a high degree of confidence his drugs aren’t fakes. So why am I buying Tamiflu? Surely if anyone in my family needed it, we’d already be at the hospital, you may think. But we lived through Sars, and I reported on it for the BMJ. I remember that nearly 300 people here died, and although no-one in the government or Hospital Authority has ever publicly said so, I was told off the record, and it’s considered common knowledge among the population here, that many of those people went to hospital as they were told to do by the Department of Health if they had a fever, and contracted Sars while they were there.

If swine flu, or its swine/avian/ human derivative makes it to Hong Kong, the last place I would want to be if I had a sniffle is anywhere near a hospital unless I was sure I needed to be there. So at least we have a dose of antivirals in our medicine cabinet, and have the option of avoiding a hospital. I wouldn’t take them, nor would my husband unless it was a last resort, but it feels better having them. I can imagine many doctors’ hair standing on end at the thought of ‘civilians’ having their own access to such drugs, and surely easy access to antiviral and antibiotic drugs in Asia has contributed to drug resistance, but I can tell you I’m not alone in my mistrust of the local medical system. My pharmacist sold out of Tamiflu today. I know, because I bought the last packet. He’s got an order in for lots more though, and a waiting list ready to snap them up.

27 April 2009

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